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Ploumen EH, Semedo E, Doggen CJM, Schotborgh CE, Anthonio RL, Danse PW, Benit E, Aminian A, Stoel MG, Hartmann M, van Houwelingen KG, Scholte M, Roguin A, Linssen GCM, Zocca P, von Birgelen C. Ethnic minorities treated with new-generation drug-eluting coronary stents in two European randomised clinical trials. Neth Heart J 2024; 32:254-261. [PMID: 38776038 PMCID: PMC11143136 DOI: 10.1007/s12471-024-01873-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Several ethnic minorities have an increased risk of cardiovascular events, but previous European trials that investigated clinical outcome after coronary stenting did not assess the patients' ethnic background. AIMS To compare ethnic minority and Western European trial participants in terms of both cardiovascular risk profile and 1‑year clinical outcome after percutaneous coronary intervention. METHODS In the BIO-RESORT and BIONYX randomised trials, which assessed new-generation drug-eluting stents, information on patients' self-reported ethnic background was prospectively collected. Pooled patient-level data of 5803 patients, enrolled in the Netherlands and Belgium, were analysed in this prespecified analysis. The main endpoint was target vessel failure after 1 year. RESULTS Patients were classified as belonging to an ethnic minority (n = 293, 5%) or of Western European origin (n = 5510, 95%). Follow-up data were available in 5772 of 5803 (99.5%) patients. Ethnic minority patients were younger, less often female, more often current smokers, more often medically treated for diabetes, and more often had a positive family history of coronary artery disease. The main endpoint target vessel failure did not differ between ethnic minority and Western European patients (3.5% vs 4.9%, hazard ratio 0.71, 95% confidence interval 0.38-1.33; p = 0.28). There was also no difference in mortality, myocardial infarction, and repeat revascularisation rates. CONCLUSIONS Despite the unfavourable cardiovascular risk profile of ethnic minority patients, short-term clinical outcome after treatment with contemporary drug-eluting stents was highly similar to that in Western European patients. Further efforts should be made to ensure the enrolment of more ethnic minority patients in future coronary stent trials.
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Affiliation(s)
- Eline H Ploumen
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands
- Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Edimir Semedo
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands
- Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Carine J M Doggen
- Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | | | - Rutger L Anthonio
- Department of Cardiology, Treant Zorggroep, Scheper Hospital, Emmen, The Netherlands
| | - Peter W Danse
- Department of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Edouard Benit
- Department of Cardiology, Jessa Hospital, Hasselt, Belgium
| | - Adel Aminian
- Department of Cardiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium
| | - Martin G Stoel
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Marc Hartmann
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands
| | - K Gert van Houwelingen
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Martijn Scholte
- Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Ariel Roguin
- Department of Cardiology, Hillel Yaffe Medical Centre, Hadera and B. Rappaport-Faculty of Medicine, Israel, Institute of Technology, Haifa, Israel
| | - Gerard C M Linssen
- Department of Cardiology, Hospital Group Twente, Almelo, The Netherlands
| | - Paolo Zocca
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Clemens von Birgelen
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands.
- Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
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Ferroni E, Guzzinati S, Andreotti A, Baracco S, Baracco M, Bovo E, Carpin E, Dal Cin A, Greco A, Fiore A, Memo L, Monetti D, Rizzato S, Stocco JE, Stocco C, Zamberlan S, Zorzi M. Cancer incidence in immigrants by geographical area of origin: data from the Veneto Tumour Registry, Northeastern Italy. Front Oncol 2024; 14:1372271. [PMID: 38863631 PMCID: PMC11165053 DOI: 10.3389/fonc.2024.1372271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/12/2024] [Indexed: 06/13/2024] Open
Abstract
Objective We investigated whether there are differences in cancer incidence by geographical area of origin in North-eastern Italy. Methods We selected all incident cases recorded in the Veneto Tumour Registry in the period 2015-2019. Subjects were classified, based on the country of birth, in six geographical areas of origin (Italy, Highly Developed Countries-HDC, Eastern Europe, Asia, Africa, South-central America). Age-standardized incidence rates and incidence rate ratio (IRR) were calculated, for all cancer sites and for colorectal, liver, breast and cervical cancer separately. Results We recorded 159,486 all-site cancer cases; 5.2% cases occurred in subjects born outside Italy, the majority from High Migratory Pressure Countries (HMPC) (74.3%). Incidence rates were significantly lower in subjects born in HMPC in both sexes. Immigrants, in particular born in Asia and Africa, showed lower rates of all site cancer incidence. The lowest IRR for colorectal cancer was observed in males from South-Central America (IRR 0.19, 95%CI 0.09-0.44) and in females from Asia (IRR 0.32, 95%CI 0.18-0.70). The IRR of breast cancer appeared significantly lower than Italian natives in all female populations, except for those coming from HDC. Females from Eastern Europe showed a higher IRR for cervical cancer (IRR 2.02, 95%CI 1.57-2.61). Conclusion Cancer incidence was found lower in subjects born outside Italy, with differences in incidence patterns depending on geographical area of origin and the cancer type in question. Further studies, focused on the country of birth of the immigrant population, would help to identify specific risk factors influencing cancer incidence.
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Jensen NK, Frøslev T, Foverskov E, Glymour M, Sørensen HT, Hamad R. The association of neighborhood socioeconomic characteristics with cardiovascular health: A quasi-experimental study of refugees to Denmark. Health Place 2023; 84:103128. [PMID: 37844523 PMCID: PMC10823536 DOI: 10.1016/j.healthplace.2023.103128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/22/2023] [Accepted: 09/22/2023] [Indexed: 10/18/2023]
Abstract
Neighborhood socioeconomic disadvantage is associated with cardiovascular health, although it is unclear which specific aspects of neighborhoods matter most. We leveraged a natural experiment in which refugees to Denmark were quasi-randomly assigned to neighborhoods across the country during 1986-1998, creating variation in exposure to various aspects of neighborhood disadvantage. The cohort was followed through December 2018. Exposures included neighborhood-level family income, educational attainment, unemployment, and welfare transfers measured in the first neighborhood after arrival to Denmark. Outcomes included cardiovascular risk factors (hyperlipidemia, hypertension, diabetes and anxiety/depression) and cardiovascular disease (acute myocardial infarction and ischemic heart disease). Neighborhood-level income and education were most consistently associated with cardiovascular risk factors, whereas welfare transfers were most consistently associated with cardiovascular disease. Addressing these specific aspects of neighborhood disadvantage could therefore lower the risk of poor cardiovascular health among refugees. Future research is warranted to examine if results are generalizable to other immigrant groups, countries or time periods.
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Affiliation(s)
- Natasja Koitzsch Jensen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Trine Frøslev
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Else Foverskov
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Maria Glymour
- Department of Epidemiology, Boston University, School of Public Health, Boston, MA, USA
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Rita Hamad
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
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Højstrup S, Thomsen JH, Prescott E. Disparities in cardiovascular disease and treatment in the Nordic countries. THE LANCET REGIONAL HEALTH. EUROPE 2023; 33:100699. [PMID: 37953994 PMCID: PMC10636266 DOI: 10.1016/j.lanepe.2023.100699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/27/2023] [Accepted: 07/10/2023] [Indexed: 11/14/2023]
Abstract
The Nordic countries, including Denmark, Finland, Iceland, Norway, and Sweden have seen a steep decline in cardiovascular mortality in recent decades. They are among the most egalitarian countries by several measures, and all have universal, publicly funded welfare systems providing healthcare for all citizens. However, despite these seemingly ideal conditions, disparities in access to cardiovascular care and outcomes persist. To address this challenge, The Lancet Region Health-Europe convened experts from a broad range of countries to summarize the current state of knowledge on cardiovascular disease disparities across Europe. This Series Paper presents the main challenges in Nordic countries based on evidence from high-quality nationwide registries. Focusing on major cardiovascular health determinants, areas in need of improvement were identified. There is a need for addressing structural causes underlying these disparities, such as poverty and discrimination, but also to improve access to healthcare in deprived neighborhoods and to address underlying social determinants of health that may mitigate disparities in cardiovascular outcomes. Overall, while the Nordic countries have made great strides in promoting egalitarianism and providing universal healthcare, there is still much work to be done to ensure equitable access to care and improved cardiovascular outcomes for all members of society.
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Affiliation(s)
- Signe Højstrup
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Jakob Hartvig Thomsen
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Eva Prescott
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
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Collatuzzo G, Ferrante M, Ippolito A, Di Prima A, Colarossi C, Scarpulla S, Boffetta P, Sciacca S. Cancer in Migrants: A Population-Based Study in Italy. Cancers (Basel) 2023; 15:3103. [PMID: 37370713 DOI: 10.3390/cancers15123103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/02/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Migrants are a vulnerable and neglected population. We aimed at investigating cancer proportionate rates in migrants in Sicily, Southern Italy. METHODS We extracted data on new cancer cases diagnosed between 2004 and 2019 from the Eastern Sicily cancer registry. We compared the adjusted proportionate morbidity ratio (PMR) for the most common cancer types among migrants and non-migrants. We fitted multivariate logistic regression models comparing one cancer to all other cancers to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for migration status. The analysis was stratified by region of origin. RESULTS Overall, 4726 new cancer cases occurred in migrants between 2004 and 2019, 63.5% of those among women and 224,211 in non-migrants, including 54.5% among men, with odds for migrants/non-migrants of 2.1%. Migrants had an increased proportion of cervical (PMR = 2.68, 95% CI = 2.29-3.10) and lung cancer (PMR = 1.20, 95% CI = 1.07-1.33). The highest OR in migrants was observed for cervical cancer (OR = 3.54, 95% CI = 2.99-4.20). Colorectal cancer was decreased among migrants (OR = 0.86, 95% CI = 0.77-0.96). CONCLUSIONS Migrants to Sicily have higher odds of cervical cancer and a decreased risk of colorectal cancer compared to non-migrants. Increased odds were also detected for lung cancer, in particular in women. Different cancer patterns could be observed based on the region of origin. HPV-related cancers need targeted attention in migrants living in Sicily.
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Affiliation(s)
- Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Margherita Ferrante
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, University of Catania, 95123 Catania, Italy
| | - Antonella Ippolito
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, University of Catania, 95123 Catania, Italy
| | - Alessia Di Prima
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, University of Catania, 95123 Catania, Italy
| | | | | | - Paolo Boffetta
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, University of Catania, 95123 Catania, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA
- Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
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Shabnam J, Timm HU, Nielsen DS, Raunkiaer M. Development of a complex intervention (safe and secure) to support non-western migrant patients with palliative care needs and their families. Eur J Oncol Nurs 2023; 62:102238. [PMID: 36459811 DOI: 10.1016/j.ejon.2022.102238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE International evidence supports the benefits of early use of palliative care, although the best use of services is often under-utilised among Danish migrants. The study aims to develop a theoretically informed, evidence-based intervention to increase support in palliative care service provision among non-western migrant patients with a life-threatening disease and their families in Denmark. METHODS The overall approach was guided by the United Kingdom Medical Research Council framework for developing and evaluating complex interventions by involving stakeholders for example patients, family caregivers, and healthcare professionals. The intervention was developed iteratively by incorporating theory and evidence. Evidence was synthesized from a systematic review, semi-structured interviews, and group discussions with patients (n = 8), family caregivers (n = 11), healthcare professionals (n = 10); and three workshops with migrants (n = 5), social and healthcare professionals (n = 6). The study took place in six different settings in two regions across Denmark. RESULTS The safe and secure complex intervention is a healthcare professional (e.g. nurse, physiotherapist, or occupational therapist) led patient-centred palliative care intervention at the basic level. The final intervention consists of three components 1. Education and training sessions, 2. Consultations with the healthcare professional, and 3. Coordination of care. CONCLUSION This study describes the development of a supportive palliative care intervention for non-western migrant patients with palliative care needs and their families, followed by a transparent and systematic reporting process. A palliative care intervention combining multiple components targeting different stakeholders, is expected that safe and secure is more suitable and well customized in increasing access and use of palliative care services for non-western migrant families in Denmark.
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Affiliation(s)
- Jahan Shabnam
- REHPA, Danish Knowledge Centre of Rehabilitation and Palliative Care, Odense University Hospital, Vestergade 17, 5800 Nyborg, Denmark; Department of Clinical Research, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark.
| | - Helle Ussing Timm
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455, Copenhagen, K, Denmark; University Hospitals Center for Health Research (UCSF), Rigshospital, Denmark.
| | - Dorthe Susanne Nielsen
- Geriatric Department G, Odense, Odense University Hospital, Kløvervænget 23, 5000, Odense C, Denmark.
| | - Mette Raunkiaer
- REHPA, Danish Knowledge Centre of Rehabilitation and Palliative Care, Odense University Hospital, Vestergade 17, 5800 Nyborg, Denmark; Department of Clinical Research, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark.
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Al-Rousan T, AlHeresh R, Saadi A, El-Sabrout H, Young M, Benmarhnia T, Han BH, Alshawabkeh L. Epidemiology of cardiovascular disease and its risk factors among refugees and asylum seekers: Systematic review and meta-analysis. INTERNATIONAL JOURNAL OF CARDIOLOGY CARDIOVASCULAR RISK AND PREVENTION 2022; 12:200126. [PMID: 35199106 PMCID: PMC8851152 DOI: 10.1016/j.ijcrp.2022.200126] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/31/2021] [Accepted: 01/28/2022] [Indexed: 01/10/2023]
Abstract
Background Methods and results Conclusions
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Affiliation(s)
- Tala Al-Rousan
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
- Corresponding author. Herbert Wertheim School of Public Health, 9500 Gilman Dr., La Jolla, CA, 92093, USA.
| | - Rawan AlHeresh
- Department of Occupational Therapy, Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA
| | - Altaf Saadi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hannah El-Sabrout
- University of California San Francisco Medical School, San Francisco, CA, USA
| | - Megan Young
- Department of Occupational Therapy, Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, USA
| | - Benjamin H. Han
- Division of Geriatrics, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Laith Alshawabkeh
- Division of Cardiovascular Medicine, Department of Medicine, University of California San Diego, La Jolla, CA, USA
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Evaluation of Surgical Procedures Needed for Refugees in Turkey:Retrospective study. JOURNAL OF CONTEMPORARY MEDICINE 2021. [DOI: 10.16899/jcm.948165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Vancheri F, Tate AR, Henein M, Backlund L, Donfrancesco C, Palmieri L, Strender LE. Time trends in ischaemic heart disease incidence and mortality over three decades (1990-2019) in 20 Western European countries: systematic analysis of the Global Burden of Disease Study 2019. Eur J Prev Cardiol 2021; 29:396-403. [PMID: 34487157 DOI: 10.1093/eurjpc/zwab134] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 06/05/2021] [Accepted: 07/31/2021] [Indexed: 12/14/2022]
Abstract
AIMS To investigate and compare changes in the rates of ischaemic heart disease (IHD) incidence and mortality between 1990 and 2019 in 20 high-income Western European countries with similar public health systems and low cardiovascular risk. METHODS AND RESULTS The 2020 updated version of the Global Burden of Disease database was searched. Variability and differences in IHD incidence and mortality rates (per 100 000) between countries over time, were calculated. A piecewise linear (join point) regression model was used to identify the slopes of these trends and the points in time at which significant changes in the trends occur. Ischaemic heart disease incidence and mortality rates varied widely between countries but decreased for all between 1990 and 2019. The relative change was greater for mortality than for incidence. Ischaemic heart disease incidence rates declined by approximately 36% between 1990 and 2019, while mortality declined by approximately 60%. Breakpoint analysis showed that the largest decreases in incidence and mortality occurred between 1990 and 2009 (-32%, -52%, respectively), with a much slower decrease after that (-5.9%, -17.6%, respectively), and even a slight increase for some countries in recent years. The decline in both incidence and mortality was lower in the Mediterranean European countries compared to the Nordic and Central European regions. CONCLUSIONS In the Western European countries studied, the decline in age-standardized IHD incidence over three decades was slower than the decline in age-standardized IHD mortality. Decreasing trends of both IHD incidence and mortality has substantially slowed, and for some countries flattened, in more recent years.
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Affiliation(s)
- Federico Vancheri
- Department of Internal Medicine, S.Elia Hospital, viale Luigi Monaco, 93100 Caltanissetta, Italy
| | | | - Michael Henein
- Institute of Public Health and Clinical Medicine, Umea University, 90187 Umea, Sweden
| | | | - Chiara Donfrancesco
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Rome, Italy
| | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Rome, Italy
| | - Lars-Erik Strender
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE 141 83 Huddinge, Sweden
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The effect of migration on the incidence and mortality of bloodstream infection: a Danish register-based cohort study. Clin Microbiol Infect 2021; 27:1474-1480. [PMID: 33549766 DOI: 10.1016/j.cmi.2021.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/17/2021] [Accepted: 01/26/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To investigate bloodstream infection (BSI) related to migrant status by comparing the incidence and mortality in migrants with that in non-migrants. METHODS In this register-based cohort study we linked a cohort of migrants and non-migrants with a bacteraemia database covering two regions in Denmark. We included first-time BSI between January 2000 and December 2015 in individuals ≥18 years. Migrants were categorized according to status: refugees or family-reunified migrants. Incidence rate ratio and mortality rate ratio were analysed using Poisson regression. RESULTS We identified 493 080 non-migrants, of which 3405 had BSI, and 80 740 migrants with 576 cases; of the latter, 40 222 were family-reunified migrants with 226 cases and 40 518 were refugees with 350 cases. Refugees had a higher risk of BSI than non-migrants (adjusted IRR 1.19, 95%CI 1.01-1.40). Family-reunified migrants and refugees had a higher risk of Gram-negative BSIs (adjusted IRR 1.23, 95%CI 1.00-1.51 and 1.57, 95%CI 1.32-1.86), respectively, and a lower risk of Gram-positive BSIs (adjusted IRR 0.65, 95%CI 0.51-0.83 and 0.77, 95%CI 0.63-0.95), respectively, compared to non-migrants. Originating from Southeast Asia and the Pacific was associated with an increased risk of BSI compared to non-migrants (adjusted IRR 1.26, 95%CI 1.07-1.49). We found no differences in the adjusted 30-day or 90-day mortality according to migrant status. CONCLUSIONS Vulnerability towards BSI differs according to migrant status. Refugees had a higher risk of BSI overall. Both refugees and family-reunified migrants had a higher incidence of Gram-negative BSI than non-migrants. Similarly, migrants from Southeast Asia and the Pacific had a higher risk of BSI than non-migrants.
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Shabbir A, Virk ST, Malik J, Kausar S, Nazir TB, Javed A. Coronary Artery Calcium Score: Assessment of SYNTAX Score and Prediction of Coronary Artery Disease. Cureus 2021; 13:e12704. [PMID: 33614311 PMCID: PMC7883584 DOI: 10.7759/cureus.12704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background With the advent of modern imaging technologies, non-invasive assessment of the coronary system is not only possible but its complexity and plaque burden can be quantified. This study aims to determine whether calcium score on computed tomography coronary angiography (CTCA) can be associated with the complexity of coronary artery disease (CAD), which is determined by the SYNTAX score on coronary angiography, as well as to determine which cut-off value of coronary artery calcium (CAC) score can predict severe CAD in our population. Methodology This was a cross-sectional study conducted at the Rawalpindi Institute of Cardiology, Pakistan from January 2019 to March 2020. The calcium score of all patients with low-to-intermediate pretest probability of CAD was calculated on CTCA. All patients who had significant disease on CTCA were subjected to conventional coronary angiography and SYNTAX score was calculated, which was later used to determine the association between calcium and SYNTAX score. Results A total of 90 patients were included in the study. CAC and SYNTAX score were found to be positively correlated (Pearson coefficient [r] = 0.354; p = 0.001). The total CAC score with a cut-off value of 212 recognized patients with the SYNTAX score of >27. The sensitivity was 66.7% and specificity was 70.5% with an area under the curve of 0.743. The mean calcium score of patients in our study group was 223, with the maximum score of 1,216 and the minimum score of zero. Conclusion A CAC score greater than 212 is associated with a high SYNTAX score indicating complex disease. Only age is an independent predictor of calcium score.
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Affiliation(s)
- Asma Shabbir
- Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, PAK
| | - Sana T Virk
- Internal Medicine, Air University, Islamabad, PAK
| | - Jahanzeb Malik
- Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, PAK
| | - Shabana Kausar
- Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, PAK
| | - Talha B Nazir
- Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, PAK
| | - Asim Javed
- Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, PAK
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Roikjær SG, Simonÿ CP, Timm HU. Qualitative study to explore what patients with heart failure find significant during integrated palliative care sessions in a Danish clinic. BMJ Open 2020; 10:e043955. [PMID: 33384400 PMCID: PMC7780519 DOI: 10.1136/bmjopen-2020-043955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE In the field of palliative care (PC) as it is integrated into heart failure (HF) treatment, it is essential to explore the patient experience and build on this knowledge for the further development of PC practice and policy. Based on an intervention study, this paper explores what patients with HF find significant in integrated sessions using a narrative S' approach. DESIGN We conducted a semistructured interview study with a qualitative analysis focused on meaning making. The study follows the guidelines of Consolidated Criteria for Reporting Qualitative Research. PARTICIPANTS AND SETTING The inclusion criteria for the PC intervention were (1) a new diagnosis of HF, (2) follow-up treatment at this local Danish HF clinic and (3) informed consent to participate in the integrated PC intervention. The only exclusion criterion was if the patient was already engaged in a PC programme. 20 patients agreed to participate in the intervention, and 12 of these completed the S' approach sessions and participated in this interview study. RESULTS Overall, the analysis showed that the integrated S' approach sessions were successful in joining an embodied patient perspective with a medical perspective. The thematic analysis resulted in three themes supporting the overall findings: sessions bring comfort, telling your story provides a sense of meaningfulness, and integrating perspectives of HF into everyday life. CONCLUSION The method using the S' approach in integrated PC and HF sessions was significant in various ways. First, patients experienced a calm and safe atmosphere and perceived that the nurse was truly interested in them. Second, the integrated sessions based on the S' approach were able to bring comfort to lived physical, psychosocial and existential issues. Last, it allowed patients to combine their embodied understanding of HF with a medical perspective, thereby finding meaning in the sense of how everything is connected.
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Affiliation(s)
- Stine Gundtoft Roikjær
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Medicine 2 Cardiology, Næstved, Slagelse and Ringsted Hospitals, Region Zealand, Denmark
- REHPA, Knowledge Center for Rehabilitation and Palliative Care, Nyborg, Denmark
| | - Charlotte Paaske Simonÿ
- Institute for Public Health, University of Aarhus, Aarhus, Denmark
- Department of Research, Næstved, Slagelse and Ringsted Hospitals, Region Zealand, Denmark
| | - Helle Ussing Timm
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- REHPA, Knowledge Center for Rehabilitation and Palliative Care, Nyborg, Denmark
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Country of birth and mortality risk in hypertension with and without diabetes: the Swedish primary care cardiovascular database. J Hypertens 2020; 39:1155-1162. [PMID: 33298686 DOI: 10.1097/hjh.0000000000002744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Hypertension and diabetes are common and are both associated with high cardiovascular morbidity and mortality. We aimed to investigate associations between mortality risk and country of birth among hypertensive individuals in primary care with and without concomitant diabetes, which has not been studied previously. In addition, we aimed to study the corresponding risks of myocardial infarction and ischemic stroke. METHODS This observational cohort study of 62 557 individuals with hypertension diagnosed 2001-2008 in the Swedish Primary Care Cardiovascular Database assessed mortality by the Swedish Cause of Death Register, and myocardial infarction and ischemic stroke by the National Patient Register. Cox regression models were used to estimate study outcome hazard ratios by country of birth and time updated diabetes status, with adjustments for multiple confounders. RESULTS During follow-up time without diabetes using Swedish-born as reference, adjusted mortality hazard ratios per country of birth category were Finland: 1.26 (95% confidence interval 1.15-1.38), high-income European countries: 0.84 (0.74-0.95), low-income European countries: 0.84 (0.71-1.00) and non-European countries: 0.65 (0.56-0.76). The corresponding adjusted mortality hazard ratios during follow-up time with diabetes were high-income European countries: 0.78 (0.63-0.98), low-income European countries: 0.74 (0.57-0.96) and non-European countries: 0.56 (0.44-0.71). During follow-up without diabetes, the corresponding adjusted hazard ratio of myocardial infarction was increased for Finland: 1.16 (1.01-1.34), whereas the results for ischemic stroke were inconclusive. CONCLUSION In Sweden, hypertensive immigrants (with the exception for Finnish-born) with and without diabetes have a mortality advantage, as compared to Swedish-born.
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Saeed S, Kanaya AM, Bennet L, Nilsson PM. Cardiovascular risk assessment in South and Middle-East Asians living in the Western countries. Pak J Med Sci 2020; 36:1719-1725. [PMID: 33235604 PMCID: PMC7674869 DOI: 10.12669/pjms.36.7.3292] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Nearly a quarter of the world population lives in the South Asian region (India, Pakistan, Bangladesh, Sri Lanka, Nepal, Bhutan, and the Maldives). Due to rapid demographic and epidemiological transition in these countries, the burden of non-communicable diseases is growing, which is a serious public health concern. Particularly, the prevalence of pre-diabetes, diabetes and atherosclerotic cardiovascular disease (CVD) is increasing. South Asians living in the West have also substantially higher risk of CVD and mortality compared with white Europeans and Americans. Further, as a result of global displacement over the past three decades, Middle-Eastern immigrants now represent the largest group of non-European immigrants in Northern Europe. This vulnerable population has been less studied. Hence, the aim of the present review was to address cardiovascular risk assessment in South Asians (primarily people from India, Pakistan and Bangladesh), and Middle-East Asians living in Western countries compared with whites (Caucasians) and present results from some major intervention studies. A systematic search was conducted in PubMed to identify major cardiovascular health studies of South Asian and Middle-Eastern populations living in the West, relevant for this review. Results indicated an increased risk of CVD. In conclusion, both South Asian and Middle-Eastern populations living in the West carry significantly higher risk of diabetes and CVD compared with native white Europeans. Lifestyle interventions have been shown to have beneficial effects in terms of reduction in the risk of diabetes by increasing insulin sensitivity, weight loss as well as better glycemic and lipid control.
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Affiliation(s)
- Sahrai Saeed
- Sahrai Saeed, Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Alka M Kanaya
- Alka M. Kanaya, Department of Medicine and Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Louise Bennet
- Louise Bennet, Department of Clinical Sciences, Family Medicine, Lund University Malmo, Sweden
| | - Peter M Nilsson
- Peter M Nilsson, Department of Clinical Sciences, Lund University, Skane University Hospital, Malmo, Sweden
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Hamad R, Öztürk B, Foverskov E, Pedersen L, Sørensen HT, Bøtker HE, White JS. Association of Neighborhood Disadvantage With Cardiovascular Risk Factors and Events Among Refugees in Denmark. JAMA Netw Open 2020; 3:e2014196. [PMID: 32821923 PMCID: PMC7442927 DOI: 10.1001/jamanetworkopen.2020.14196] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
IMPORTANCE Refugees are among the most disadvantaged individuals in society, and they often have elevated risks of cardiovascular risk factors and events. Evidence is limited regarding factors that may worsen cardiovascular health among this vulnerable group. OBJECTIVE To test the hypothesis that refugee placement in socioeconomically disadvantaged neighborhoods is associated with increased cardiovascular risk. DESIGN, SETTING, AND PARTICIPANTS The study population of this quasi-experimental, registry-based cohort study included 49 305 adults 18 years and older who came to Denmark as refugees from other countries during the years of Denmark's refugee dispersal policy from 1986 to 1998. Refugees were dispersed to neighborhoods with varying degrees of socioeconomic disadvantage in an arbitrary manner conditional on observed characteristics. The association of neighborhood disadvantage on arrival with several cardiovascular outcomes in subsequent decades was evaluated using regression models that adjusted for individual, family, and municipal characteristics. Health outcomes were abstracted from the inpatient register, outpatient specialty clinic register, and prescription drug register through 2016. Data analysis was conducted from May 2018 to July 2019. EXPOSURES A composite index of neighborhood disadvantage was constructed using 8 neighborhood-level socioeconomic characteristics derived from Danish population register data. MAIN OUTCOMES AND MEASURES Primary study outcomes included hypertension, hyperlipidemia, type 2 diabetes, myocardial infarction, and stroke. Before data analysis commenced, it was hypothesized that higher levels of neighborhood disadvantage were associated with an increased risk of cardiovascular risk factors and events. RESULTS A total of 49 305 participants were included (median [interquartile range] age, 30.5 [24.9-39.8] years; 43.3% women). Participant region of origin included 6318 from Africa (12.8%), 7253 from Asia (14.7%), 3446 from Eastern Europe (7.0%), 5416 from Iraq (11.0%), 6206 from Iran (12.6%), 5558 from Palestine (via Lebanon, Israel, Occupied Palestinian Territories; 11.3%), and 15 108 from Yugoslavia (30.6%). Adjusted models revealed an association between placement in disadvantaged neighborhoods and increased risk of hypertension (0.71 [95% CI, 0.30-1.13] percentage points per unit of disadvantage index; P < .01), hyperlipidemia (0.44 [95% CI, 0.06-0.83] percentage points; P = .01), diabetes (0.45 [95% CI, 0.09-0.81] percentage points; P = .01), and myocardial infarction (0.14 [95% CI, 0.03-0.25] percentage points; P = .01). No association was found for stroke. Individuals who arrived in Denmark before age 35 years had an increased risk of hyperlipidemia (1.16 [95% CI, 0.41-1.92] percentage points; P < .01), and there were no differences by sex. CONCLUSIONS AND RELEVANCE In this quasi-experimental cohort study, neighborhood disadvantage was associated with increased cardiovascular risk in a relatively young population of refugees. Neighborhood characteristics may be an important consideration when refugees are placed by resettlement agencies and host countries. Future work should examine additional health outcomes as well as potential mediating pathways to target future interventions (eg, neighborhood ease of walking, employment opportunities).
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Affiliation(s)
- Rita Hamad
- Philip R. Lee Institute for Health Policy Studies, University of California School of Medicine, San Francisco
- Department of Family & Community Medicine, University of California School of Medicine, San Francisco
| | - Buket Öztürk
- Department of Clinical Epidemiology, Aarhus University, Denmark
| | - Else Foverskov
- Philip R. Lee Institute for Health Policy Studies, University of California School of Medicine, San Francisco
- Department of Clinical Epidemiology, Aarhus University, Denmark
| | - Lars Pedersen
- Department of Clinical Epidemiology, Aarhus University, Denmark
| | - Henrik T. Sørensen
- Department of Clinical Epidemiology, Aarhus University, Denmark
- Center for Population Health Science, Stanford University, Stanford, California
| | - Hans E. Bøtker
- Department of Cardiology, Aarhus University Hospital, Denmark
| | - Justin S. White
- Philip R. Lee Institute for Health Policy Studies, University of California School of Medicine, San Francisco
- Department of Epidemiology & Biostatistics, University of California School of Medicine, San Francisco
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Agyemang C, Norredam M. Neighborhood Environment Has a Profound Association With Refugees' Health. JAMA Netw Open 2020; 3:e2014355. [PMID: 32821918 DOI: 10.1001/jamanetworkopen.2020.14355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Charles Agyemang
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, University of Amsterdam, the Netherlands
| | - Marie Norredam
- Danish Research Centre for Migration, Ethnicity and Health, Section of Health Services Research, Department of Public Health, University of Copenhagen, Denmark
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Denli Yalvac ES. Cardiovascular diseases and their risk factors among Syrian refugees in Turkey. Rev Epidemiol Sante Publique 2020; 68:137-144. [PMID: 32139199 DOI: 10.1016/j.respe.2019.11.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 10/20/2019] [Accepted: 11/03/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Information on the world distribution of cardiovascular disease and its risk factors in refugees/migrants is not available at the same rate for all countries or for different ethnic and socioeconomic groups. Today, Syria's humanitarian catastrophe has become a public health concern, which cannot be ignored. METHODS A search was conducted across PubMed and Google Scholar for papers on cardiovascular diseases among refugees/migrants worldwide with a focus on Syrian in Turkey. RESULTS The total number of papers identified through the database searches and from reference lists was 486. Of these, 62 were found to be relevant after further screening. A further 42 papers were considered not eligible after full-text, language and data assessments, resulting in a final 20 papers included in the qualitative analysis. These studies discussed several major themes: cardiovascular diseases and their risk factors among refugees/migrants, the effects of changing living conditions on refugees/migrants, the effects of psychological and socioeconomic factors, and the prevention and treatment of cardiovascular diseases in refugees/migrants. The risk of cardiovascular disease varied by country of origin, country of destination, and duration of residence. The findings suggest that cardiovascular diseases and their risk factors are increased for Syrian refugees in Turkey. CONCLUSION Raising awareness, prevention, early detection, and good management as well as monitoring and reporting of risk factors are the key components to controlling cardiovascular diseases in refugees. Further studies and greater acquisition of survey data are urgently needed.
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Affiliation(s)
- E S Denli Yalvac
- Department of Cardiovascular Surgery, Göztepe Education and Research Hospital, Istanbul Medeniyet University, Kadiköy, Istanbul, Turkey.
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Aggarwal R, Dwivedi S, Vohra N. Is migration stress related to increased cardiovascular diseases? MGM JOURNAL OF MEDICAL SCIENCES 2020. [DOI: 10.4103/mgmj.mgmj_49_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Jin K, Neubeck L, Koo F, Ding D, Gullick J. Understanding Prevention and Management of Coronary Heart Disease Among Chinese Immigrants and Their Family Carers: A Socioecological Approach. J Transcult Nurs 2019; 31:257-266. [DOI: 10.1177/1043659619859059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Introduction: Health disparities among immigrants exist across socioecological domains. While Chinese immigrants face increased risk for coronary heart disease (CHD) after migration, the reasons are not well understood. Method: This descriptive qualitative study collected 18 semistructured interviews with Chinese immigrants with CHD and family carers from two Australian hospitals. Analysis was guided by the social–ecological model. Results: Poor knowledge and limited English proficiency increased CHD risk and difficulty navigating health care systems/resources. Interpersonal and family factors positively influenced health-seeking behaviors, acceptance of cardiac procedures, adoption of secondary preventive behaviors and information acquisition through social networks. A lack of culturally specific health information and programs in Chinese languages was described. Ethnic concordance between Chinese doctors and patients improved health literacy and engendered trust. Discussion: Culturally specific interventions could include health promotion materials in Chinese, inclusion of family in educational programs, and Chinese-focused public health campaigns about warning signs of heart attack.
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Affiliation(s)
- Kai Jin
- University of Sydney, Camperdown, New South Wales, Australia
| | | | - Fung Koo
- University of Sydney, Camperdown, New South Wales, Australia
| | - Ding Ding
- University of Sydney, Camperdown, New South Wales, Australia
| | - Janice Gullick
- University of Sydney, Camperdown, New South Wales, Australia
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20
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Impact of Length of Residence in the United States on Risk of Diabetes and Hypertension in Resettled Refugees. J Immigr Minor Health 2019; 20:296-306. [PMID: 28852919 DOI: 10.1007/s10903-017-0636-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The relationship between resettlement and development of chronic disease has yet to be elucidated in refugees. We aimed to assess the relationship between length of residence in the US and development of diabetes and hypertension utilizing multivariable logistic regression models in a sample of former refugee patients seeking primary care services. Multivariable logistic regression models adjusting for age, gender, and country of origin showed significantly increasing odds of type 2 diabetes (OR 1.12, 95% CI 1.03-1.22, p < 0.01) and hypertension (OR 1.07, 95% CI 1.00-1.14) with increasing length of stay in the US for resettled refugee adults. A significant proportion of diabetes (26.7%) and hypertension (36.9%) diagnoses were made within one year of arrival, highlighting the critical role of focusing diagnosis and prevention of chronic disease in newly resettled refugees, and continuing this focus throughout follow-up as these patients acculturate to their new homeland.
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Pallesen AVJ, Byberg S, Kristiansen M. Improving Dietary Behavior Among Ethnic Minority Women in Denmark: A Feasibility Study Based on a Participatory and Culturally Adapted Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050795. [PMID: 30841498 PMCID: PMC6427310 DOI: 10.3390/ijerph16050795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/14/2019] [Accepted: 02/28/2019] [Indexed: 11/16/2022]
Abstract
The Danish Heart Foundation and the non-governmental organization Neighborhood Mothers have co-developed a culturally adapted intervention seeking to promote healthy dietary behaviour among ethnic minority women. This feasibility study explores the potential of the intervention to reach ethnic minority women using health promotion initiatives. Participants attended instructor courses or cooking events, where culturally adapted, healthy recipes were introduced and meals prepared. Feasibility was explored using a mixed-method approach. Surveys were completed by 59 volunteers and 150 participants at five instructor courses and 21 cooking events. Individual interviews and focus group discussions were conducted with volunteers and participants after completion of the intervention. After the intervention, 61% of the 150 participants had high levels of knowledge about dietary recommendations, 96% intended to cook healthy dishes in the future and 84% intended to incorporate measuring equipment into their daily cooking routine. Participants with a high level of knowledge reported intention to change dietary behaviour more often than participants with lower levels of knowledge. Interviews confirmed that the participants cooked healthy dishes after participating, and incorporated knowledge about healthy food practices into their daily cooking. Few participants used measuring equipment. The intervention proved to be feasible as a health promotion initiative targeting a hard-to-reach population.
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Affiliation(s)
- Anna Vera Jørring Pallesen
- Department of Public Health & Center for Healthy Aging, University of Copenhagen, 1014 Copenhagen, Denmark.
| | - Stine Byberg
- Steno Diabetes Center Copenhagen, 2820 Copenhagen, Denmark.
| | - Maria Kristiansen
- Department of Public Health & Center for Healthy Aging, University of Copenhagen, 1014 Copenhagen, Denmark.
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Morbach C, Gelbrich G, Tiffe T, Eichner F, Wagner M, Heuschmann PU, Störk S, Frantz S, Maack C, Ertl G, Fassnacht M, Wanner C, Leyh R, Volkmann J, Deckert J, Faller H, Jahns R. Variations in cardiovascular risk factors in people with and without migration background in Germany - Results from the STAAB cohort study. Int J Cardiol 2018; 286:186-189. [PMID: 30420145 DOI: 10.1016/j.ijcard.2018.10.098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/02/2018] [Accepted: 10/29/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND About 20% of the German population have a migration background which might influence prevalence of preventable cardiovascular risk factors (CVRF). METHODS We report data of the prospective Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) cohort study investigating a representative sample of inhabitants of the City of Würzburg, Germany, aged 30 to 79 years. Individuals without migration background were defined as follows: German as native language, no other native language, and/or born in Germany. All other participants were defined as individuals with migration background. RESULTS Of 2473 subjects (51% female, mean age 54 ± 12 years), 291 (12%) reported a migration background: n = 107 (37%) from a country within the EU, n = 117 (40%) from Russia, and n = 67 (23%) from other countries. Prevalence of hypertension, atherosclerotic disease, and diabetes mellitus was similar in individuals with and without migration background. By contrast, prevalence of obesity and metabolic syndrome was significantly higher in individuals with migration background, with the least favourable profile apparent in individuals from Russia (individuals without vs. with migration background: obesity 19 vs. 24%, p < 0.05; odds ratio: EU: 1.6, Russia: 2.2*, other countries: 0.6; metabolic syndrome 18 vs. 21%, p < 0.05; odds ratio: EU: 1.2, Russia: 1.7*, other countries: 1.5; *p < 0.05). CONCLUSION Individuals with migration background in Germany might exhibit a higher CVRF burden due to a higher prevalence of obesity and metabolic syndrome. Strategies for primary prevention of heart failure may benefit from deliberately considering the migration background.
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Affiliation(s)
- Caroline Morbach
- Comprehensive Heart Failure Center and Dept. of Medicine I, University Hospital and University of Würzburg, Germany
| | - Götz Gelbrich
- Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany
| | - Theresa Tiffe
- Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany
| | - Felizitas Eichner
- Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany
| | - Martin Wagner
- Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany
| | - Peter U Heuschmann
- Institute of Clinical Epidemiology and Biometry, Comprehensive Heart Failure Center, and Clinical Trial Center, University of Würzburg, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center and Dept. of Medicine I, University Hospital and University of Würzburg, Germany.
| | | | - S Frantz
- Dept. of Medicine I, Div. of Cardiology, University Hospital Würzburg, Germany
| | - C Maack
- Comprehensive Heart Failure Center, University Hospital and University of Würzburg, Germany
| | - G Ertl
- University Hospital Würzburg, Germany
| | - M Fassnacht
- Dept. of Medicine I, Div. of Endocrinology, University Hospital Würzburg, Germany
| | - C Wanner
- Dept. of Medicine I, University Hospital Würzburg, Germany
| | - R Leyh
- Dept. of Cardiovascular Surgery, University Hospital Würzburg, Germany
| | - J Volkmann
- Dept. of Neurology, University Hospital Würzburg, Germany
| | - J Deckert
- Dept. of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Germany
| | - H Faller
- Dept. of Medical Psychology, University of Würzburg, Germany
| | - R Jahns
- Interdisciplinary Bank of Biomaterials and Data Würzburg, University Hospital Würzburg, Germany
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Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, Cooney MT, Corrà U, Cosyns B, Deaton C, Graham I, Hall MS, Hobbs FDR, Løchen ML, Löllgen H, Marques-Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders Y, Tiberi M, Bart van der Worp H, van Dis I, Verschuren WMM. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Atherosclerosis 2018; 252:207-274. [PMID: 27664503 DOI: 10.1016/j.atherosclerosis.2016.05.037] [Citation(s) in RCA: 339] [Impact Index Per Article: 56.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | - Ugo Corrà
- Societie: European Society of Cardiology (ESC)
| | | | | | - Ian Graham
- Societie: European Society of Cardiology (ESC)
| | | | | | | | | | | | - Joep Perk
- Societie: European Society of Cardiology (ESC)
| | | | - Josep Redon
- Societie: European Society of Hypertension (ESH)
| | | | - Naveed Sattar
- Societie: European Association for the Study of Diabetes (EASD)
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Sahin M, Öztürk S, Mert TI, Durmuş G, Can MM. Coronary artery bypass surgery in Syrian refugees. Outcomes in a Turkish tertiary center. Saudi Med J 2018; 39:781-786. [PMID: 30106415 PMCID: PMC6194983 DOI: 10.15537/smj.2018.8.22498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To assess outcomes of Syrian refugees undergoing coronary artery bypass surgery in a tertiary hospital in Turkey. METHODS We sought for in-hospital mortality and one year all-cause mortality as the main outcomes. We reviewed records of 67 Syrian and 427 Turkish patients undergoing isolated coronary bypass surgery between 2015 January and 2017 January retrospectively. Results: History of coronary, peripheral and carotid artery diseases and obesity were more frequent in Syrian patients. C-reactive protein levels were higher in Syrian patients whereas lipid profiles and systolic functions of the 2 groups were similar. Syrian patients more frequently presented with the acute coronary syndrome (26.9% versus 15.5%, p<0.001). SYNTAX I (Synergy between PCI with Taxus and Cardiac Surgery) and SYNTAX II-PCI were higher in Syrian patients whereas SYNTAX II-CABG was similar with Turkish patients. Extubation time was longer and amount of the hemorrhage was greater in Syrian patients; however, bleeding revision was not increased. Although wound infection was more frequent in Syrian patients, postoperative complications were similar between groups. In-hospital mortality and one year all-cause mortality did not differ between Syrian (n=1; 1.5% versus n=13; 13.1%) (p=0.476) and Turkish patients (n=3; 4.5% versus n=25; 5.9%) (p=0.63). CONCLUSION Syrian patients had higher SYNTAX I and SYNTAX II PCI scores, but not SYNTAX II CABG score compared with Turkish patients. Intraoperative and postoperative complications were similar. In-hospital mortality and one year all-cause mortality of Syrian patients were similar with Turkish patients. Surgical outcomes of Syrian patients were acceptable. Primary prevention of obesity must be provided. Aggressive secondary preventive measures must be taken due to increased severity of coronary artery disease.
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Affiliation(s)
- Mazlum Sahin
- Department of Cardiology, Haseki Training and Research Hospital, Millet Cadddesi Aksaray, Fatih, Istanbul, Turkey. E-mail.
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Boateng D, Agyemang C, Beune E, Meeks K, Smeeth L, Schulze M, Addo J, de-Graft Aikins A, Galbete C, Bahendeka S, Danquah I, Agyei-Baffour P, Owusu-Dabo E, Mockenhaupt FP, Spranger J, Kengne AP, Grobbee DE, Stronks K, Klipstein-Grobusch K. Migration and Cardiovascular Disease Risk Among Ghanaian Populations in Europe: The RODAM Study (Research on Obesity and Diabetes Among African Migrants). Circ Cardiovasc Qual Outcomes 2018; 10:CIRCOUTCOMES.117.004013. [PMID: 29150534 DOI: 10.1161/circoutcomes.117.004013] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 10/05/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND For migrant populations from sub-Saharan Africa, adverse cardiovascular disease (CVD) risk factors have been observed to be higher than found in their home country-based counterparts or among the host populations in high-income countries. Differences in absolute overall CVD risk, however, remain largely unexplained. We, therefore, predicted the differences in 10-year CVD risk among sub-Saharan African migrants (Ghanaians) living in 3 European cities and Ghana. METHODS AND RESULTS For 3864 subjects aged 40 to 70 years from the multicenter RODAM study (Research on Obesity and Diabetes Among African Migrants) conducted among Ghanaian adults residing in rural and urban Ghana and 3 European cities (Amsterdam, Berlin, and London), 10-year risk of CVD was estimated using the Pooled Cohort Equations with estimates ≥7.5% defining high CVD risk. Logistic regressions were used to determine the association of migration on CVD risk. The proportion with CVD risk ≥7.5% among Ghanaian men was 34.7% in rural Ghana, 45.4% in urban Ghana, 53.9% in Amsterdam, 61.0% in Berlin, and 52.2% in London. Compared with rural Ghana, CVD risk was significantly increased for Ghanaian men living in Berlin (adjusted odds ratio, 2.80; 95% confidence interval, 1.76-4.45) and Amsterdam (1.88; 1.25-2.84). Increased risk observed for men was largely not seen for women. CVD risk increased with longer stay in Europe. CONCLUSIONS Knowledge about predictors of increased CVD risk among sub-Saharan African migrants in Europe and nonmigrants in urban centers will inform and support targeted health care and interventions to these populations.
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Affiliation(s)
- Daniel Boateng
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.).
| | - Charles Agyemang
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.)
| | - Erik Beune
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.)
| | - Karlijn Meeks
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.)
| | - Liam Smeeth
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.)
| | - Matthias Schulze
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.)
| | - Juliet Addo
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.)
| | - Ama de-Graft Aikins
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.)
| | - Cecilia Galbete
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.)
| | - Silver Bahendeka
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.)
| | - Ina Danquah
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.)
| | - Peter Agyei-Baffour
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.)
| | - Ellis Owusu-Dabo
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.)
| | - Frank P Mockenhaupt
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.)
| | - Joachim Spranger
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.)
| | - Andre P Kengne
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.)
| | - Diederick E Grobbee
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.)
| | - Karien Stronks
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.)
| | - Kerstin Klipstein-Grobusch
- From Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands (D.B., D.E.G., K.K.-G.); School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (D.B., P.A.B., E.O.-D.); Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands (C.A., E.B., K.M., K.S.); Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom (L.S., J.A.); Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (M.S., C.G., I.D.); Regional Institute for Population Studies, University of Ghana, Legon, Ghana (A.d.-G.A.); Mother Kevin Postgraduate Medical School, Uganda Martyrs University, Kampala (S.B.); Kumasi Centre for Collaborative Research, Kwame NKrumah University of Science and Technology, Ghana (E.O.-D.); Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Germany (F.P.M.); Charite Center for Cardiovascular Research, Berlin, Germany (J.S.); Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa (A.P.K.); and Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (K.K.-G.)
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26
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Song YS, Choi SW. Low Estimated Glomerular Filtration Rate Is Prevalent among North Korean Refugees in South Korea. Korean J Fam Med 2018; 39:161-167. [PMID: 29788704 PMCID: PMC5975986 DOI: 10.4082/kjfm.2018.39.3.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 03/06/2017] [Accepted: 03/06/2017] [Indexed: 12/02/2022] Open
Abstract
Background The number of North Korean refugees entering South Korea is rising. Few studies have investigated the risk of non-communicable disease in North Korean refugees. Moreover, kidney insufficiency, a risk factor for cardiovascular disease, has not been studied in this population. We compared the prevalence of non-communicable disease and kidney function in North Korean refugees and South Koreans. Methods Our study was conducted using a case-control design. We enrolled 118 North Korean refugees from the Hana Center and selected 472 randomly sampled South Korean individuals as controls, who were age- and sex-matched with the North Korean refugees in a ratio of 1:4, from the 2014 Korea National Health and Nutrition Examination Survey database. Results The prevalence of non-communicable disease did not differ significantly between the groups; however, a low estimated glomerular filtration rate (eGFR; <90 mL/min per 1.73 m2) was more prevalent in the North Korean refugees than in the South Korean population (52.1% vs. 29.9%, P<0.001). After adjusting for covariates and weight gain after escape, the prevalence of a low eGFR was associated with the length of residence in South Korea (odds ratio, 2.84; 95% confidence interval, 1.02–7.89). Conclusion The prevalence of non-communicable disease did not differ between North Korean refugees and the South Korean population, while a low eGFR was more prevalent in North Korean refugees than in South Koreans. Moreover, after adjusting for other covariates, the prevalence of a low eGFR in North Korean refugees was associated with the length of residence in South Korea.
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Affiliation(s)
- Young-Soo Song
- Department of Health Science, Graduate School of Chosun University, Gwangju, Korea
| | - Seong-Woo Choi
- Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea
- Corresponding Author: Seong-Woo Choi Tel: +82-62-230-6344, Fax: +82-62-225-8293, E-mail:
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27
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Perini W, Snijder MB, Peters RJG, Stronks K, Kunst AE. Increased cardiovascular disease risk in international migrants is independent of residence duration or cultural orientation: the HELIUS study. J Epidemiol Community Health 2018; 72:825-831. [PMID: 29730606 DOI: 10.1136/jech-2018-210595] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 04/10/2018] [Accepted: 04/23/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND International migrants differ from host populations in cardiovascular disease (CVD) risk. It has been postulated that these disparities narrow with longer residence duration. Our aim was to determine whether CVD risk still differs between migrants and host population after decades of residence and to determine whether this potential convergence of CVD risk would occur mainly among migrants with a strong cultural orientation towards the host culture. METHODS In the Healthy Life in an Urban Setting study, we obtained data regarding residence duration, cultural orientation as estimated by the Psychological Acculturation Scale and CVD risk as estimated by SCORE among the Dutch host population and first generation migrants from South-Asian Surinamese, African Surinamese, Moroccan and Turkish ethnic background residing in Amsterdam. Estimated CVD risk was compared with the Dutch, separately for medium-term residence (15-30 years) or long-term residence (>30 years) migrants, and by strong/weak cultural orientation towards the Dutch culture, using age-adjusted regression analyses. RESULTS Among 8672 participants without prior CVD, estimated CVD risk was higher among migrant groups relative to the Dutch. CVD risk relative to the Dutch did not differ by residence duration (betas ranging from 0.1 to 3.4 for medium-term and from 0.6 to 3.3 for long-term residence, respectively). Furthermore, these patterns did not differ by cultural orientation towards the Dutch culture. CONCLUSION We find no indication that CVD risk among South-Asian Surinamese, African Surinamese, Turkish or Moroccan migrants converges to that of the Dutch host population with increasing residence duration, not even among those with strong cultural orientation towards the host culture.
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Affiliation(s)
- Wilco Perini
- Department of Public Health, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands.,Department of Cardiology, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands
| | - Marieke B Snijder
- Department of Public Health, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Ron J G Peters
- Department of Cardiology, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands
| | - Karien Stronks
- Department of Public Health, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands
| | - Anton E Kunst
- Department of Public Health, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands
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28
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Odone A, McKee C, McKee M. The impact of migration on cardiovascular diseases. Int J Cardiol 2018; 254:356-361. [PMID: 29407123 DOI: 10.1016/j.ijcard.2017.11.084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Accepted: 11/22/2017] [Indexed: 12/21/2022]
Affiliation(s)
- Anna Odone
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Charlotte McKee
- Department of War Studies, Kings College London, United Kingdom
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom.
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29
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Rabanal KS, Meyer HE, Tell GS, Igland J, Pylypchuk R, Mehta S, Kumar B, Jenum AK, Selmer RM, Jackson R. Can traditional risk factors explain the higher risk of cardiovascular disease in South Asians compared to Europeans in Norway and New Zealand? Two cohort studies. BMJ Open 2017; 7:e016819. [PMID: 29217719 PMCID: PMC5728264 DOI: 10.1136/bmjopen-2017-016819] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The objective was to prospectively examine potential differences in the risk of first cardiovascular disease (CVD) events between South Asians and Europeans living in Norway and New Zealand, and to investigate whether traditional risk factors could explain any differences. METHODS We included participants (30-74 years) without prior CVD in a Norwegian (n=16 606) and a New Zealand (n=129 449) cohort. Ethnicity and cardiovascular risk factor information was linked with hospital registry data and cause of death registries to identify subsequent CVD events. We used Cox proportional hazards regression to investigate the relationship between risk factors and subsequent CVD for South Asians and Europeans, and to calculate age-adjusted HRs for CVD in South Asians versus Europeans in the two cohorts separately. We sequentially added the major CVD risk factors (blood pressure, lipids, diabetes and smoking) to study their explanatory role in observed ethnic CVD risk differences. RESULTS South Asians had higher total cholesterol (TC)/high-density lipoprotein (HDL) ratio and more diabetes at baseline than Europeans, but lower blood pressure and smoking levels. South Asians had increased age-adjusted risk of CVD compared with Europeans (87%-92% higher in the Norwegian cohort and 42%-75% higher in the New Zealand cohort) and remained with significantly increased risk after adjusting for all major CVD risk factors. Adjusted HRs for South Asians versus Europeans in the Norwegian cohort were 1.57 (95% CI 1.19 to 2.07) in men and 1.76 (95% CI 1.09 to 2.82) in women. Corresponding figures for the New Zealand cohort were 1.64 (95% CI 1.43 to 1.88) in men and 1.39 (95% CI 1.11 to 1.73) in women. CONCLUSION Differences in TC/HDL ratio and diabetes appear to explain some of the excess risk of CVD in South Asians compared with Europeans. Preventing dyslipidaemia and diabetes in South Asians may therefore help reduce their excess risk of CVD.
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Affiliation(s)
- Kjersti S Rabanal
- Division for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Haakon E Meyer
- Division for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Grethe S Tell
- Division for Health Data and Digitalisation, Norwegian Institute of Public Health, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Romana Pylypchuk
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Suneela Mehta
- School of Population Health, University of Auckland, Auckland, New Zealand
| | | | - Anne Karen Jenum
- Faculty of Health and Society, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Randi M Selmer
- Division for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Rod Jackson
- School of Population Health, University of Auckland, Auckland, New Zealand
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30
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García-Granja PE, Amat-Santos IJ, Amado MG. Cardiopatía isquémica en inmigrantes de Europa del Este en España: experiencia unicéntrica. Med Clin (Barc) 2017; 148:476-478. [DOI: 10.1016/j.medcli.2017.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 01/10/2017] [Accepted: 01/12/2017] [Indexed: 10/20/2022]
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31
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2016 European Guidelines on cardiovascular disease prevention in clinical practice. Int J Behav Med 2017; 24:321-419. [DOI: 10.1007/s12529-016-9583-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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32
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Permanand G, Krasnik A, Kluge H, McKee M. Europe's migration challenges: mounting an effective health system response. Eur J Public Health 2016; 26:3-4. [PMID: 26839337 DOI: 10.1093/eurpub/ckv249] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Govin Permanand
- WHO Regional Office for Europe (and London School of Economics and Political Science), Copenhagen, Denmark
| | - Allan Krasnik
- European Public Health Association, Migrant Health Section and University of Copenhagen Copenhagen, Denmark
| | - Hans Kluge
- WHO Regional Office for Europe, Copenhagen, Denmark
| | - Martin McKee
- European Public Health Association and London School of Hygiene and Tropical Medicine, London, UK
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Greve B. Migrants and health in the Nordic welfare states. Public Health Rev 2016; 37:9. [PMID: 29450051 PMCID: PMC5809879 DOI: 10.1186/s40985-016-0023-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 08/11/2016] [Indexed: 12/23/2022] Open
Abstract
This article probes into the health of migrants with a focus on the situation in the Nordic universal welfare states. The Nordic welfare states are further compared to each other with a comparison to the EU28 if possible, including investigation of the differences among the four Nordic countries. This is done by analyzing central parameters related to access to and inequality in health care. The article concludes that ethnicity does not give rise by itself to differences in health care, including access to care, but can be seen as a marker of where health problems might arise due to other specific socioeconomic factors, such as the impact of economic inequality. Moreover, the healthy migrant paradox cannot be confirmed.
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Affiliation(s)
- Bent Greve
- University of Roskilde, Roskilde, Denmark
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34
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Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, Cooney MT, Corrà U, Cosyns B, Deaton C, Graham I, Hall MS, Hobbs FDR, Løchen ML, Löllgen H, Marques-Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WMM. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2016; 37:2315-2381. [PMID: 27222591 PMCID: PMC4986030 DOI: 10.1093/eurheartj/ehw106] [Citation(s) in RCA: 4405] [Impact Index Per Article: 550.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Massimo F. Piepoli
- Corresponding authors: Massimo F. Piepoli, Heart Failure Unit, Cardiology Department, Polichirurgico Hospital G. Da Saliceto, Cantone Del Cristo, 29121 Piacenza, Emilia Romagna, Italy, Tel: +39 0523 30 32 17, Fax: +39 0523 30 32 20, E-mail: ,
| | - Arno W. Hoes
- Arno W. Hoes, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500 (HP Str. 6.131), 3508 GA Utrecht, The Netherlands, Tel: +31 88 756 8193, Fax: +31 88 756 8099, E-mail:
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35
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Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, Cooney MT, Corrà U, Cosyns B, Deaton C, Graham I, Hall MS, Hobbs FDR, Løchen ML, Löllgen H, Marques-Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WMM, De Backer G, Roffi M, Aboyans V, Bachl N, Bueno H, Carerj S, Cho L, Cox J, De Sutter J, Egidi G, Fisher M, Fitzsimons D, Franco OH, Guenoun M, Jennings C, Jug B, Kirchhof P, Kotseva K, Lip GYH, Mach F, Mancia G, Bermudo FM, Mezzani A, Niessner A, Ponikowski P, Rauch B, Rydén L, Stauder A, Turc G, Wiklund O, Windecker S, Zamorano JL. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts): Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur J Prev Cardiol 2016; 23:NP1-NP96. [PMID: 27353126 DOI: 10.1177/2047487316653709] [Citation(s) in RCA: 578] [Impact Index Per Article: 72.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | - Ugo Corrà
- Societies: European Society of Cardiology (ESC)
| | | | | | - Ian Graham
- Societies: European Society of Cardiology (ESC)
| | | | | | | | | | | | - Joep Perk
- Societies: European Society of Cardiology (ESC)
| | | | | | | | - Naveed Sattar
- European Association for the Study of Diabetes (EASD)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Leslie Cho
- Societies: European Society of Cardiology (ESC)
| | | | | | | | - Miles Fisher
- European Association for the Study of Diabetes (EASD)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Lars Rydén
- Societies: European Society of Cardiology (ESC)
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Johansson H, Odén A, Lorentzon M, McCloskey E, Kanis JA, Harvey NC, Karlsson MK, Mellström D. Is the Swedish FRAX model appropriate for Swedish immigrants? Osteoporos Int 2015; 26:2617-22. [PMID: 26018091 DOI: 10.1007/s00198-015-3180-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 05/14/2015] [Indexed: 11/24/2022]
Abstract
UNLABELLED The incidence of hip fracture in Sweden is substantially lower in immigrants than in the population born in Sweden. Thus, the use of a FRAX® model in immigrants overestimates the risk of fracture, and the use of country of origin-specific models may be more appropriate. INTRODUCTION Age-specific fracture and mortality rates vary between countries so that FRAX tools are country-specific. In the case of immigrants, it is not known whether the model for the original or the new country is most appropriate. The aim of this study was to compare the incidence of hip fractures in foreign-born and Swedish-born individuals residing in Sweden. METHODS We studied the incidence of hip fracture in all men and women aged 50 years or more in Sweden between 1987 and 2002. The population comprised 2.8 million Swedish-born and 270,000 foreign-born individuals. RESULTS Incident hip fractures occurred in 239,842 Swedish-born and 12,563 foreign-born individuals. The hip fracture incidence rose with age for both groups and was higher for women than men amongst both Swedish-born and foreign-born individuals. The hip fracture incidence for the Swedish-born cohort was approximately twice that of immigrants. For example, at the age of 70 years, the annual hip fracture incidence (per 100,000) was 450 (95 % CI 446-454) for a Swedish-born woman and 239 (95 % CI 223-257) for a foreign-born woman at the time of immigration. The hip fracture incidence rose slowly with time from immigration (0.6 % per annum, 95 % CI 0.5-0.8 %) but remained significantly lower than for Swedish-born individuals even after 40 years of residence. CONCLUSIONS The incidence of hip fracture in Sweden is substantially lower in immigrants than in the population native to Sweden. Although there was a small rise in age- and sex-specific incidence after immigration, the incidence remained markedly lower than that observed in Swedish-born individuals. Thus, the use of a FRAX model for Sweden will overestimate the risk of fracture for foreign-born individuals living in Sweden.
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Affiliation(s)
- H Johansson
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.
- Centre for Bone and Arthritis Research (CBAR), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - A Odén
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
| | - M Lorentzon
- Centre for Bone and Arthritis Research (CBAR), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - E McCloskey
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
| | - J A Kanis
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - M K Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmo, Sweden
| | - D Mellström
- Centre for Bone and Arthritis Research (CBAR), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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37
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Rabanal KS, Selmer RM, Igland J, Tell GS, Meyer HE. Ethnic inequalities in acute myocardial infarction and stroke rates in Norway 1994-2009: a nationwide cohort study (CVDNOR). BMC Public Health 2015; 15:1073. [PMID: 26487492 PMCID: PMC4612407 DOI: 10.1186/s12889-015-2412-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Accepted: 10/12/2015] [Indexed: 12/15/2022] Open
Abstract
Background Immigrants to Norway from South Asia and Former Yugoslavia have high levels of cardiovascular disease (CVD) risk factors. Yet, the incidence of CVD among immigrants in Norway has never been studied. Our aim was to study the burden of acute myocardial infarction (AMI) and stroke among ethnic groups in Norway. Methods We studied the whole Norwegian population (n = 2 637 057) aged 35–64 years during 1994–2009. The Cardiovascular Disease in Norway (CVDNOR) project provided information about all AMI and stroke hospital stays for this period, as well as deaths outside hospital through linkage to the Cause of Death Registry. The direct standardization method was used to estimate age standardized AMI and stroke event rates for immigrants and ethnic Norwegians. Rate ratios (RR) with ethnic Norwegians as reference were calculated using Poisson regression. Results The highest risk of AMI was seen in South Asians (men RR = 2.27; 95 % CI 2.08–2.49; women RR = 2.10; 95 % CI 1.76–2.51) while the lowest was seen in East Asians (RR = 0.38 in both men (95 % CI 0.25–0.58) and women (95 % CI 0.18–0.79)). Immigrants from Former Yugoslavia and Central Asia also had increased risk of AMI compared to ethnic Norwegians. South Asians had increased risk of stroke (men RR = 1.26; 95 % CI 1.10–1.44; women RR = 1.58; 95 % CI 1.32–1.90), as did men from Former Yugoslavia, Sub-Saharan Africa and women from Southeast Asia. Conclusions Preventive measures should be aimed at reducing the excess numbers of CVD among immigrants from South Asia and Former Yugoslavia. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2412-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kjersti S Rabanal
- Division of Epidemiology, Norwegian Institute of Public Health, P.O. Box 4404, Nydalen, 0403, Oslo, Norway.
| | - Randi M Selmer
- Division of Epidemiology, Norwegian Institute of Public Health, P.O. Box 4404, Nydalen, 0403, Oslo, Norway.
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, N-5018, Bergen, Norway.
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, N-5018, Bergen, Norway. .,Department of Health Registries, Norwegian Institute of Public Health, Kalfarveien 31, 5018, Bergen, Norway.
| | - Haakon E Meyer
- Division of Epidemiology, Norwegian Institute of Public Health, P.O. Box 4404, Nydalen, 0403, Oslo, Norway. .,Department of Community Medicine, Institute of Health and Society, University of Oslo, P.O. Box 1130, Blindern, 0318, Oslo, Norway.
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